An unusual large radicular cyst : a case report

The radicular cyst is the most common inflammatory odontogenic cyst of the jaws. It usually originates from the epithelial residues as a sequel to a periapical inflammatory process, following chemical, physical or bacterial injury .Due to its chronic etiology, the cyst usually appears towards the later stage of life. The incidence of radicular cysts is greater in the third to sixth decades and shows a slight male predominance. Many radicular cysts are symptomless. The classic radiological appearance of radicular cysts is a round or ovoid radiolucencies surrounded by a narrow radiopaque margin in periapical region.Case report An 78-year-old male with history of respiratory and heart disease reported to Department of Oral and Maxillofacial surgery ,College of Alborz university of medical science with the chief complaint of painless swelling on the lower left side of face and mandibular vestibule that prevented him from wearing denture. Radiographic examination revealed a large well-defined unilocular radiolucency of impacted third molar extending from left anterior mandibular region to left condyle. An incisional biopsy was done. Based on clinical, radiographical and histopathological findings, the present case was diagnosed as an unusual large radicular cyst.Discussion Radicular cysts are inflammatory odontogenic cysts which generally associated with the root apex of a carious tooth due to the presence of necrotic pulp. Prevalence of the radicular cysts in the maxilla is 60% as compared with mandible. Owing to its clinical and specially radiographic characteristics, differential diagnosis should include dentigerous cyst, ameloblastoma, odontogenic keratocyst.The clinical and radiological characteristics of this cyst could be considered as an unusual due to its giant size and position.Considering the age of the patient, size of lesion, marsupialization was preferred as a conservative treatment of choice.

Keywords:

Radicular cyst , Impacted tooth , Large cyst